Narrative Review on Perioperative Shivering during Caesarean Section under Neuraxial Anaesthesia

Perioperative shivering is a well-known complication reported in 29 to 54% of patients undergoing a caesarean section under regional anaesthesia. It interferes with pulse oximetry, blood pressure (BP), and electrocardiographic monitoring (ECG). Moreover, it gives the patient a distressing and unpleasant experience. This review aims to examine the mechanism of shivering during the caesarean section under neuraxial anaesthesia and to explore available information for preventing and managing this clinically significant complication.

A literature search of PubMed, MedLine, Science Direct, and Google Scholar was done. The search results were limited to randomised controlled trials (RCT) and systematic reviews.

This review studied the efficacy of various nonpharmacological and pharmacological methods to manage perioperative shivering. We found that pre-warming and intraoperative warming are simple and effective interventions, although the effect seems to depend on the duration of treatment. Multiple pharmacological interventions, including opioids, NMDA receptor antagonists, and alpha-2 adrenergic agonists, have been studied and found to reduce the incidence and severity of perioperative shivering during caesarean section under neuraxial anaesthesia.